The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
Office of Emergency Medical Services
2 Boylston Street, 3rd Floor
Boston, MA 02116
(617) 753-7300
Fax: (617) 753-7320

MITT ROMNEY
GOVERNOR
KERRY HEALEY
LIEUTENANT GOVERNOR
TIMOTHY R. MURPHY
SECRETARY
PAUL J. COTE, JR.
COMMISSIONER	
Response Time and Service Zone Planning

I.	All service zones must set a response time standard and put it in their service zone plans: Under the state’s EMS System regulations, local standards for various EMS performance criteria, including response time, must be specified in the service zone plan. Each service zone application must document the local response time standard, and how the service zone is defining that. That is, the service zone application must describe from what starting point in time to what ending point the response time standard measures.

II.	Defining Start and End Points for Response Time: Local service zones can define the start and end points for their measure of response time in setting their standard, consistent with National EMS Information System Dataset (NEMSIS) definitions for various EMS call points in time, as set out in the 2005 National Highway Transportation Safety Administration (NHTSA) Uniform Prehospital Dataset document. Please note that NEMSIS has no definition for “response time,” but rather defines specific points in time during an EMS call as data elements. Here are six points in time defined in NEMSIS:

•	PSAP Call Date/Time – The time the phone rings (911 call to public safety answering point or other designated entity) requesting EMS services.
•	Dispatch Notified Date/Time – The time dispatch was notified by the 911 call taker (if a separate entity)
•	Unit Notified by Dispatch Date/Time – The time the responding unit was notified by dispatch
•	Unit En Route Date/Time – The time the unit responded; that is, the time the vehicle started moving
•	Unit Arrived on Scene Date/Time – The time the responding unit arrived on scene; that is, the time the vehicle stopped moving
•	Arrived at Patient Date/Time – The time the responding unit arrived at the patient’s side.

III.	Recommendations on Appropriate Response Time Standards: In setting their response time standards, local service zones will want to consider such factors such as available system resources, geography, population density, community expectations, and ultimately, best patient care to determine what constitutes an acceptable response time standard. Nationally recognized response time standards, guidelines and recommendations can be found in publications such as the National Fire Protection Association’s NFPA 1710 and NFPA 450, the American Ambulance Association’s The Community Guide to Ensure High-Performance Emergency Ambulance Service, the National Association of State EMS Physicians’ (NAEMSP) 2003 position paper, Considerations in Establishing EMS Response Time Goals, and the National Highway Transportation Administration’s (NHTSA)/NAEMSP/American College of Emergency Physicians (ACEP)’s Medical Direction: National Standard Curriculum, “Module 2: EMS Systems.” Regional EMS Councils will gladly provide specific recommendations and assistance to every Service Zone that requests it.